The Power Of Neurofeedback: Recent Studies

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Neurofeedback research has been historically underfunded for two main reasons. Firstly, because it is not medication-based, pharmaceutical companies who typically fund large double-blind studies have no incentive to do so. Secondly, a pioneering study from the 1970’s revealed significant differences in brainwave activity among regular meditators. This generated considerable interest in both the scientific and the new-age community. However, the connection between neurofeedback and transcendental states led to a stigma that caused the scientific community to shy away from exploring neurofeedback as a treatment for neurological and psychological disorders. Early studies often suffered from poor experimental design and lacked standardized protocols which limited the value of findings. This situation is rapidly changing as the cost of neurofeedback technology has significantly decreased. What once cost $30,000 to $40,000 in equipment can now be accessed for under $1,000. Growing research, especially in Europe and Canada, is being led by respected figures such as Ruth Lanius. Increasing public interest—fueled in part by advocates like Bessel Van Der Kolk, author of The Body Keeps the Score—is attracting more research funding. Below are some of the latest studies demonstrating neurofeedback’s effectiveness in treating PTSD, trauma, anxiety, depression, insomnia, and ADHD.

Neurofeedback for post-traumatic stress disorder: systematic review and meta-analysis of clinical and neurophysiological outcomes 

https://pubmed.ncbi.nlm.nih.gov/37732560/ 

This review looked at how effective Electroencephalographic Neurofeedback (NFB) is for treating PTSD by analyzing ten clinical trials. The results showed that NFB significantly reduced PTSD symptoms, as well as symptoms of anxiety and depression, and it also seemed to cause changes in brain activity. In the studies reviewed, 79.3% of participants in the NFB group showed improvement, compared to just 24.4% in the control group. However, the studies were generally small, with diverse populations and varying quality. Overall, NFB showed moderate effectiveness in reducing PTSD symptoms, and the brain changes it caused suggest it could be a useful treatment. Future research should involve larger, more carefully designed studies with longer follow-up periods. 

The impact of neurofeedback training on children with developmental trauma: A randomized controlled study 

https://pubmed.ncbi.nlm.nih.gov/32658503/ 

This pilot study looked at the effects of neurofeedback training (NFT) on 37 children aged 6-13 with a history of severe abuse and neglect. These children often don't respond well to traditional therapies. The children were randomly split into two groups: one received 24 sessions of NFT, while the other group received standard treatment. The results showed that the NFT group had significant improvements in PTSD symptoms, emotional and behavioral issues, and executive functioning (like attention and impulse control). The study suggests that NFT could help children with developmental trauma by improving learning, self-esteem, and social relationships, especially for those who haven't had success with other treatments. 

Bessel Van Der Kolk's (author of The Body Keeps The Score) Research https://traumaresearchfoundation.org/wp-content/uploads/2021/05/NF-PLOS-ONE-FFF.pdf 

https://traumaresearchfoundation.org/wp-content/uploads/2021/05/Child-NF-paper-6_12_2020-FF.pdf

These pilot studies show statistically significant benefit for patients with PTST and developmental trauma. They are small and not peer reviewed. 

Neurofeedback for insomnia: Current state of research 

https://pubmed.ncbi.nlm.nih.gov/34733650/ 

Chronic insomnia affects a significant portion of the population, and while existing treatments are available, they each have drawbacks. Neurofeedback, a technique that targets abnormal brain activity, is being explored as a potential treatment for insomnia. This review examined 12 experimental studies on neurofeedback for insomnia. All studies showed improvement in subjective sleep quality, but the results on objective improvements were mixed. Neurofeedback targeting brain activity in the sensorimotor cortex showed potential benefits, though a placebo effect was noted in some studies. Despite promising findings, many studies had limitations, and more research with stronger designs is needed to fully confirm neurofeedback's effectiveness as a treatment for insomnia. 

A Randomized Controlled Trial Comparing Neurofeedback and Cognitive- Behavioral Therapy for Insomnia Patients: Pilot Study 

https://pubmed.ncbi.nlm.nih.gov/35147813/ 

This small pilot study compared the effects of neurofeedback and cognitive-behavioral treatment for insomnia (CBT-I) in adults with insomnia. Seventeen participants were randomly assigned to either neurofeedback or CBT-I. The neurofeedback group showed changes in brain activity, with reduced beta waves (which are linked to hyperarousal) and increased theta and alpha waves, suggesting a reduction in cortical arousal. Both groups showed improvements in sleep quality, with lower insomnia severity and better sleep efficiency. However, only the CBT-I group showed a significant reduction in negative thoughts about sleep. The study concluded that neurofeedback can help reduce insomnia symptoms by lowering brain hyperarousal, though it was less effective than CBT-I in reducing dysfunctional sleep-related thoughts. 

EEG Neurofeedback for Anxiety Disorders and Post-Traumatic Stress Disorders: A Blueprint for a Promising Brain-Based Therapy 

https://pubmed.ncbi.nlm.nih.gov/34714417/ 

This review looks at how EEG neurofeedback (EEG NF) may help treat anxiety and PTSD by targeting brain activity related to stress and over-arousal. These disorders are often linked to problems with the brain’s stress response and arousal systems. EEG NF is a non-invasive, drug- free treatment that helps patients learn to control their brain activity, potentially reducing symptoms of anxiety and PTSD. While there are positive reports about EEG NF’s effects, it’s still unclear whether improvements are directly due to changes in brain activity, as existing studies have some methodological issues. The review discusses the brain mechanisms involved, the strengths and weaknesses of past studies, and factors that might affect the success of EEG NF for treating these disorders. 

Efficacy Evaluation of Neurofeedback-Based Anxiety Relief 

https://pmc.ncbi.nlm.nih.gov/articles/PMC8581142/

This study looked at how mindfulness and neurofeedback can help reduce anxiety by examining brain activity changes. Thirty-four participants, half with anxiety and half healthy, went through a three-stage experiment where their brain signals were recorded during rest and mindfulness exercises. The study found that after mindfulness adjustments, the brain's gamma wave activity increased, which was linked to reduced anxiety and improved mindfulness. The results were statistically significant, suggesting that neurofeedback combined with mindfulness can help change brain activity patterns in people with anxiety, providing an objective way to assess anxiety relief. 

Correlation between amygdala BOLD activity and frontal EEG asymmetry during real- time fMRI neurofeedback training in patients with depression 

https://pubmed.ncbi.nlm.nih.gov/26958462/ 

This study explored how combining real-time fMRI neurofeedback (rtfMRI-nf) with EEG can help treat major depressive disorder (MDD). In the experiment, MDD patients learned to increase brain activity in the left amygdala while experiencing happy emotions, using rtfMRI-nf. The results showed that changes in brain activity in the frontal EEG (specifically in the alpha wave band) were linked to improvements in depression severity and better emotional regulation. The study also found that these EEG changes were connected to increased amygdala activity. This suggests that targeting the amygdala with rtfMRI-nf, along with EEG-based neurofeedback, can improve emotion regulation in MDD patients and may be a helpful treatment combination for depression. 

Neurofeedback training in major depressive disorder: A systematic review of clinical efficacy, study quality and reporting practices 

https://pubmed.ncbi.nlm.nih.gov/33587957/ 

This review looked at the effectiveness of neurofeedback as an additional treatment for major depressive disorder (MDD) in patients who didn't respond to standard treatments like therapy or medication. Out of 585 studies initially reviewed, 24 were included in the analysis, involving 480 patients in the experimental group and 194 in the control group. The results showed that most MDD patients who received neurofeedback had better symptom improvement compared to those in the control groups. However, many studies did not meet high-quality research standards. The review suggests improvements in study designs and reporting practices for future neurofeedback research in treating depression. 

 Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis 

https://pubmed.ncbi.nlm.nih.gov/29445867/ 

This meta analysis looks at the long-term effectiveness of neurofeedback (NF) in treating children with ADHD. It analyzed 10 studies that followed up with participants 2 to 12 months after treatment. The results showed that NF had a moderate to large positive effect on reducing inattention, and a smaller effect on hyperactivity/impulsivity. These effects were sustained for at least 6 months. In comparison to non-active control treatments (like no treatment), NF showed better lasting results for both inattention and hyperactivity/impulsivity. However, active treatments like medication (e.g., methylphenidate) were more effective than NF in the short term for inattention. The study suggests that more research is needed to compare NF with active treatments over time and better understand its long-term benefits. 

Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis 

https://pubmed.ncbi.nlm.nih.gov/19715181/ 

This meta analysis reviews research on neurofeedback as a treatment for ADHD, which has been used since 1976. The analysis found that neurofeedback has a strong positive effect on reducing impulsivity and inattention, and a moderate effect on hyperactivity. While randomized studies showed a smaller effect on hyperactivity, it suggests that hyperactivity might be more influenced by other factors unrelated to neurofeedback. The study addressed previous concerns about small or poorly designed studies and concluded that neurofeedback is a clinically effective treatment for ADHD, especially for inattention and impulsivity. Based on current guidelines, neurofeedback for ADHD can be considered "Efficacious and Specific," meaning it works well and targets specific ADHD symptoms. 

Mind over chatter: plastic up-regulation of the fMRI salience network directly after EEG neurofeedback 

https://pubmed.ncbi.nlm.nih.gov/23022326/ 

This study looked at how neurofeedback (NFB), a technique that helps people control their brain waves, affects brain function. Thirty-four healthy participants performed an attention task while either reducing their alpha brain waves (which are linked to relaxation and calm) or undergoing a sham (fake) feedback session. After the NFB session, those who reduced their alpha waves showed increased connectivity in brain regions responsible for alertness and attention. This change was linked to less mind-wandering while working and changes in alpha rhythm during rest. The study shows that NFB can create lasting changes in brain networks involved in focus and cognitive control, suggesting it could be useful for treating cognitive disorders. 

Neurofeedback as a Treatment Intervention in ADHD: Current Evidence and Practice 

https://pubmed.ncbi.nlm.nih.gov/31139966/ 

This meta analysis examines neurofeedback as a treatment for ADHD, highlighting its potential benefits compared to traditional treatments, which often have long-term side effects or limited effectiveness. The review looks at evidence from large studies, which show that three specific neurofeedback training protocols—theta/beta, sensori-motor rhythm, and slow cortical potential —are effective for managing ADHD symptoms. However, there is currently no regulation for how neurofeedback is implemented in clinical settings. The review suggests that neurofeedback could be a valuable treatment option for ADHD, but more research is needed to understand how these protocols work. It also calls for standardized training for practitioners and clear guidelines for clinical use.